Referrals for specialist care

You are entitled to ask for a referral for specialist treatment on the NHS. However, whether you will get the referral depends on what your GP feels is clinically necessary in your case.

If you wish to be referred to a specialist in a particular field, such as a surgeon, or a gynaecologist (a specialist in the female reproductive system), you should see the GP you are registered with. This is because all your medical records are held by that practice. Your GP also generally understands your health history and treatments better than anyone and will base any decision for a specialist referral on this knowledge.

If you ask your GP to refer you to a specialist, they will probably suggest that you first try various tests, or treatment options, to see whether your condition improves. Generally, you cannot self-refer to a specialist within the NHS, except when accessing sexual health clinics or accident and emergency (A&E) treatment.

A specialist will only see you with a letter of referral from your GP. The letter will give the specialist essential background information, such as your medical history, and it will also contain details that the specialist needs to pay particular attention to.

If you want to see a private specialist, you are still advised to get a letter of referral from your GP. However, whether you see a private specialist, with or without a GP referral, or are referred to an NHS specialist, your GP is not obliged to accept the specialist's recommendations. For more information, read Do I need a referral for private treatment?

When doctors write to each other about your care, they should aim to give you a copy of their letters or emails. If you don’t get a copy, you can ask for one.

Choosing a hospital or consultant

If you are referred to a specialist by your GP or other health professional, such as dentist or ophthalmologist, you may have the right to choose which hospital in England to go to for your first outpatient appointment.

You can also choose which consultant-led team will be in charge of your treatment. This means that if you choose a particular consultant for a procedure, you can choose to have your first outpatient appointment at the hospital where the consultant works and be treated by that consultant's team. Learn more about consultant choice.

Once you have decided on a hospital, you could book your first outpatient appointment through the NHS e-Referral Service. This can happen in the following ways:

your GP can book it while you're at the surgery

you can book it online using the Appointment Request letter your GP gives you

you can phone the NHS e-Referral Service line on 0345 6088888 (open Monday to Friday, 8am to 8pm and on weekends and bank holidays 8am to 4pm)

Under the NHS Constitution, if your GP refers you for a condition that isn’t urgent, you have the right to start treatment led by a consultant within 18 weeks from when you are referred, unless you want to wait longer or waiting longer is clinically right for you. For more information, read our guide to waiting times.

Other services you may access through your GP

As well as specialist referrals, your GP can help you find the right stop smoking services, weight loss service or other self-management programmes that help to prevent or manage a condition. Self-management programmes are not simply about educating you about your condition. They also let you take control of your health by learning new skills to manage your condition on a daily basis. These services may, however, not be available on the NHS and you may have to pay for them yourself.

Some areas may offer local schemes that allow patients to have subsidised access to gyms or weight loss services such as WeightWatchers, Slimming World or Rosemary Conley. It is worth asking your GP if there are any schemes available in your area.